This project examines the effects of psychological disorder and social need on patterns of medical care utilization, physicians' perceptions of patients' problems, treatment, and processes of referral to psychiatric services. Three samples will be surveyed in a population area with a substantial rural component served by a single large multispecialty group practice: a sample of 1000 persons representative of the community population, 300 patients from this population seeking psychiatric care, and 500 Medicaid recipients. These data will be combined with medical and pharmaceutical records for the subsequent 12-month period. Psychological disorder, social need, sociodemographic characteristics, and attitudes will be used as predictors of patterns of utilization of medical and psychiatric services, costs of care, referral by primary care practitioners to specialized psychiatric services, prescription of psychoactive drugs by primary care physicians and psychiatrists, and use of nonprescription drugs. Patterns of care will be examined in relationship to varying financial arrangements for services including prepaid group practice and fee for service. A major focus of the study is on the way in which management of psychological disorder and social need affects patterns of subsequent utilization of medical resources.